The roles of attachment and social support in post-traumatic stress among refugees and asylum seekers.

Background: Refugees and asylum seekers (RAS) are often exposed to stressors before, during, and after migration, with trauma and post-migration living difficulties (PMLD) frequently associated with elevated post-traumatic stress (PTS). Preliminary studies suggest that attachment insecurity plays a role in the link between PMLD and PTS in RAS. However, the mechanisms by which attachment insecurity mediates PTS are not well understood. Perceived social support may represent a key psychological pathway through which attachment insecurity impacts PTS.

Objectives: This study investigated 1) whether attachment insecurity (i.e. anxious and avoidant attachment) mediates the association between stressors (i.e., trauma exposure, PMLD) and PTS, and 2) whether perceived social support further mediates the relationship between attachment insecurity and PTS.

Methods: The sample comprised 407 RAS (54.0 % male; mean age 33.7 years) from eight different regions in Switzerland. Participants responded to questionnaires assessing trauma exposure, PMLD, attachment insecurity, perceived social support, and PTS. Path analysis was used to test two models: 1) a mediation model (i.e., model 1) with attachment anxiety and avoidance as mediators between stressors (i.e., trauma, PMLD) and PTS, and 2) model 1 with perceived social support as an additional mediator between attachment insecurity and PTS.

Results: Attachment anxiety and avoidance mediated the association between PMLD and PTS, but not between trauma and PTS. Perceived social support did not improve explained variance in PTS.

Conclusions: Attachment is an important psychological mechanism when studying traumatised RAS who experience substantial PMLD. The role of perceived social support needs to be further investigated.